Wednesday, December 17, 2014

Rotator cuff repair - what patient and surgical factors matter in the outcome?

Specific patient-related prognostic factors for rotator cuff repair: a systematic review.

These authors conducted a literature search up to July 2013 for prospective studies that describe prognostic factors affecting outcome in primary open or arthroscopic repair of a full-thickness supraspinatus or infraspinatus tear.

Included outcome measures were shoulder function and cuff integrity; 12 studies met the inclusion criteria..

They defined a 'moderate' effect as one supported by by statistically significant findings in outcome measures in at least 1 high-quality prognostic cohort study or supported by consistently statistically significant findings in outcome measures in at least 2 medium quality prognostic cohort studies.

We tabulated the results of this carefully done study below, showing the strength of the relationships between different variables and (1) shoulder function and (2) repair integrity

Comment: This study again shows the difference in the factors associated with poorer function and those associated with failure of the repair to achieve tendon integrity. It also reminds us that the characteristics of the tear and the patient's age are the dominant factors in determining the chances of achieving a durable repair integrity.


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